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Abstract
Background: Here, the educational and labour market characteristics of Mexican dentists are revised. Dentistry is a
health profession that has been scarcely studied in developing countries. This analysis attempts to understand the
relationships and gaps between the supply and demand of dentists in the country. Around 5000 new dentists
graduate every year looking for a place in the labour market.
Methods: A cross-sectional study with exploratory, descriptive and correlational scope was carried out between
2006 and 2008. Analyses of quantitative data on dentists from national surveys and occupational statistics were
complemented with qualitative information provided by 43 key informants in five Mexican states.
Results: The 2008 dentist labour market can be characterized as follows: 75% worked in the private sector, most of
them independently; more than two-thirds were women; the proportion of specialists was low (slightly more than
10%); unemployment was more than 20% and labour wastage was nearly 40%, with most wastage corresponding
with female dentists. The increase in the number of dentists entering the labour market during the last two
decades is more related to the educational market than to the populations health needs and the number of
dentists actually required to meet them.
Conclusions: The problems identified in the Mexican dentist labour market necessitate urgent intervention on
behalf of regulatory bodies in order to balance the tendencies of supply and demand in the number of trained
professionals as well as in their incorporation into different market areas. Adequate policies are required to increase
the likelihood of achieving this objective.
Keywords: Dentists, Education, Labor markets, Mexico
Background
The Toronto Call to Action 20062016: Towards a Decade of Human Resources for Health in the Americas [1],
establishes that human resources are the basis of the
health system and that the contribution of this work
force is a key factor in the ability of health systems to ensure equitable access to quality services for the entire
population.
The Pan American Health Organization and World
Health Organization (WHO) [2] state that the health
systems of many different countries in the Latin American and Caribbean region presently face challenges
derived from a series of problems related to human
resources. Among other challenges, Pan American
* Correspondence: luz.gonzalez@uaem.mx
Universidad Autnoma del Estado de Morelos, Calle Leeros esquina
Iztacchuatl s/n Col. Volcanes, CP 62350, Cuernavaca, Morelos, Mxico
2012 Gonzalez-Robledo et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
Methods
The results presented in this document are part of a
broader research project called Training, Employment
and Regulation of Human Resources in Health: Bases
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Page 3 of 11
2000
2008
93 557
117 449
Women
60.5
67.3
Men
39.5
32.7
Sex
Training level
Bachelors degree
95.2
88.9
Postgraduate degree
4.8
11.1
Employed
81
78.9
Unemployed
19
21.1
72.8
78.9
27.2
21.1
97.7
96.5
2.3
3.5
Private
88.2
75
Public
11.8
25
One
93.9
89.7
Two
5.8
10.3
Three
0.3
Work status
Employed
Rural
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Table 2 Types of key informants and interview topics explored (qualitative component)
Type of key informant
Category
Specific topic
Training
Labour market
Social Security
Institutions (IMSS and ISSSTE)
decision-makers
Training
Labour market
Regulation
Training
Education policies
Curricula
Terminal efficiency
Graduates
Graduate profile
Working conditions
Program accreditation
Labour market
Training
Labour Market
Regulation
HRH: Human resources for health; IMSS: Mexican Institute of Social Security; ISSSTE: Institute of Security and Social Services for State Workers.
Results
Training
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Figure 1 Dentists terminal efficiency, 19902004. Authors own estimations based on the National Association of Universities and Institutions
of Higher Education statistical yearbooks (19902004).
available to carry out the training than to populationbased oral health-care needs or institutional demand for
dentists, as is confirmed by the following testimonies:
More than thinking on how many dentists does the
state need, how many of them are practicing or how
many are trying to open a clinical practice (..), we
need to think how many students we are going to train
every year. Educator. Campeche P.8
Labour market
Table 1 demonstrates key dynamics in market composition between 2000 and 2008. The proportion of women
in the market increased from 60.5% to 67.3%, while the
percentage of dentists who are specialists more than
doubled, from 4.8% in 2000 to 11.1% in 2008. As with
other occupational groups in the health sector, dentists
are presented with a variety of options when entering
the labour market, including public sector, social security, private sector, and academic. However, as opposed to
doctors and nurses, who mainly can find a position in a
public or social security institution, the main option for
most dentists is the private sector, as shown in Figure 2.
Of the total number of dentists employed in 2000,
88.2% were practicing in a private unit. By 2008, this
percentage had dropped to 74.9% (Table 1 and Figure 3).
Although the dentists labour market has traditionally
been dominated by private individual practitioners, more
recently salaried positions appear to be gaining importance. This new trend may increase in the future as
public and private health-care institutions identify oral
care as a relevant in the supply of their health interventions [23].
Interviewed employers perceive an excessive number
of dentists in the country and assert that academic institutions train more resources than the country and health
institutions require. This exacerbates the problems with
job searching and placement of graduates in the labour
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Private offices
Public sector
25%
Private Sector
75%
Dental
centers and
clinics
Hospitals
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Figure 4 Number of dentists per 100 000 inhabitants by state, Mexico 2008. Authors own estimations based on the 2008 National
Occupation and Employment Survey (ENOE).
Page 8 of 11
100%
80%
58.9
62.3
22
16.6
19.1
21.1
2000
2008
60%
40%
20%
0%
Works in area in which he/she was trained
Works in a different area from the one in which he/she was trained
Does not work
Figure 5 Labour wastage for dentists in Mexico, 20002008. Source: 2000 National Employment Survey (ENE) and 2008 National Occupation
and Employment Survey (ENOE), National Institute of Statistics and Geography (INEGI).
Discussion
This is one of the first attempts to analyse the educational, labour market, and regulatory patterns of dentists
in Mexico using a mix-methods approach. Although our
scope was intended to be broad, the diversity of the phenomena, its determinants and its consequences are too
complex to be properly explored in a single study.
Therefore, our explanatory capacity remains somehow
general and only in very specific issues was it possible to
have a deeper understanding. Many unexplored issues
remain and they should be the subject of future research. Also the data that was used is clearly incomplete,
leaving gaps of explanation in various areas. Educational
and labour market statistical data represented the entire
country (but not specific states) and were available for
comparison across a certain period of time, while it was
only possible to obtain qualitative data in five selected
states. These methodological limitations should be initially recognized to develop a balanced interpretation of
the results presented in the previous section.
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unemployment or underemployment; and a delayed response in adapting to health-care trends (in terms of technology, new procedures, etc.). Thus, developing a human
resource policy process in dentistry would allow the production of an adequate number of professionals with the
knowledge, ability, attitude and ideal qualifications to take
appropriate actions in the right place and at the right time
to achieve established oral health objectives.
Some of the advantages of implementing policy in
dentistry are:
contributing to the improvement of the populations
Conclusions
The case analysed provides lessons for Mexico at both the
federal and state levels, as well as for other countries, in at
least the following three areas: the generation of evidence
based on the use of national surveys, censuses and other
sources of information available in the country; the identification of problematic areas requiring urgent intervention;
and the use of information by the public and private stakeholders to formulate policies aiming at developing a better
balance between supply and demand of dentists.
One relevant phenomena raised in the paper is illegal
practice. This is a complex phenomenon that requires
more research to be understood in depth. Illegal practice
clearly shows that links between educational and labour
market institutions go beyond the formal interaction. This
type of phenomenon can not be fully understood only by
the analysis of formal statistics. New ways of research
should be developed to achieve this understanding.
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doi:10.1186/1478-4491-10-31
Cite this article as: Gonzlez-Robledo et al.: Dentist education and labour
market in Mexico: elements for policy definition. Human Resources for
Health 2012 10:31.